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Biomedical subjects

M F Gates

Publications and source records attributed to M F Gates.

13 recordsLinked to original sources
PubMed2001

Adults' recollections of their experiences as young caregivers of family members with chronic physical illnesses.

AIMS OF THE STUDY: The aims of this study were to describe the number, kind, and intensity of caregiving activities performed by individuals who assumed caregiving responsibilities, as youngsters, for adults with chronic physical illnesses; to explore the meaning and effects of the caregiving experience on those individuals; and to examine positive and negative effects of caregiving then and now. BACKGROUND/RATIONALE: Family mobility, demographic changes, and health care system changes in the United States of America (USA) have contributed to an increasing number of youngsters under the age of 18 caring for adults with chronic physical illnesses in the home. The effects of such caregiving on youngsters and the long-term effects on them as adults require study. DESIGN/METHODS: This descriptive, retrospective study had a convenience sample of 51 adults (age range 19--68 years now, 3--19 years then) who cared for their family members diagnosed with cancer, stroke, cardiovascular disease, multiple sclerosis or amyotrophic lateral sclerosis, respiratory disease, diabetes, or arthritis. Demographic data and caregiving data were analysed using descriptive statistics. The semistructured interview data were analysed using content analysis. RESULTS/FINDINGS: Of the caregiving care tasks most frequently performed, personal care was most difficult and household tasks were most time consuming. Family life, school, and time with friends were areas most likely to be affected by caregiving. Most subjects indicated they would permit their own children to assist with care as long as the youngster was not the sole caregiver. Youngsters need to be informed about the illness and caregiving tasks, have adequate support systems, and have some time to 'still be a child'. CONCLUSIONS: Professional caregivers should raise questions in their practice regarding involvement in caregiving by both adults and youngsters. If youngsters participate in caregiving in the home, they need to receive adequate information regarding care and the illness trajectory. Family-related research including the long-term effects of such experiences on the youngsters and their families is recommended.

Adaptation, Psychological↗
PubMed2001

African American women's experiences with the initial discovery, diagnosis, and treatment of breast cancer.

PURPOSE/OBJECTIVES: To describe the experiences of African American women living with breast cancer following the primary diagnosis and while undergoing initial treatment. DESIGN: Phenomenologic. SAMPLE/SETTING: 13 African American women (ages 30-66) purposefully selected from two oncology clinics in the mid-South. METHODS: Phenomenologic interviews (transcribed verbatim) and field notes were analyzed using Colaizzi's method of phenomenologic description and analysis. FINDINGS: Experience Trajectory, Femininity, and Spirituality were the three major themes. The Experience Trajectory subthemes were finding the lump, getting the diagnosis, undergoing surgery and adjuvant treatment. The Femininity subthemes were loss of all or part of the breast, loss of hair, and sexual attractiveness to a man. Spirituality was reflected as a reliance on God. CONCLUSIONS: Telling the story of their experience trajectory during their breast cancer experience is valuable in assessing African American women's feelings, emotions, and fears of body changes that occur during surgery and treatment. Their spirituality helps them through this experience. Research involving both African American women and their partners would provide greater insight into specific relationship patterns and communication related to sexuality during this experience. IMPLICATIONS FOR NURSING PRACTICE: Nurses need to listen to the stories of African American women about the initial experience of discovery, diagnosis, and treatment of breast cancer so they can be more informed advocates for these women. African American women need more information from healthcare providers regarding the whole experience trajectory.

Adaptation, Psychological↗
PubMed2001

Caring demands and delay in seeking care in African American women newly diagnosed with breast cancer: an ethnographic, photographic study.

PURPOSE/OBJECTIVES: To describe the caring behaviors and demands of African American women newly diagnosed with breast cancer and to consider the influence of caring on the women's decision to delay prompt diagnosis and maintain continuing treatment. DESIGN: Focused ethnographic design using photography. SAMPLE/SETTING: 13 African American women (ages 30-66) purposefully selected from two oncology clinics in the mid-South. METHODS: Ethnographic interviews (transcribed verbatim), observations at informant-selected sites, field notes, and snapshots of caring taken by the women where caring occurred were analyzed using Lelninger's phases of ethnographic analysis. FINDINGS: Major themes were (a) generic caring for others and self as meaningful and as promoting continued commitment to diagnosis and treatment, (b) generic and professional caring from others as supportive to the women in "going on," and (c) noncaring related to a "wait and see" attitude of healthcare providers and of women in delaying early diagnosis. CONCLUSIONS: African American women's caring both for and from others was supportive in seeking and continuing diagnosis and treatment. The women with cancer viewed ensuring early diagnosis and continued treatment for other women as their "mission." Delay by providers and women requires further research. IMPLICATIONS FOR NURSING PRACTICE: Nurses must advocate assertiveness for African American women in seeking help for breast cancer symptoms and in challenging providers who adopt a "wait and see" attitude when symptoms are present. Taking snapshots, in addition to fostering the research process, is suggested as a potentially helpful intervention for women as they work through their experiences during treatment for breast cancer.

Adult↗
PubMed1999

Focus on community: directions for nursing knowledge development.

Nurses are challenged to advance the theoretical foundations of community practice. This paper offers ideas on what has been done and what needs to be done to meet this challenge. Within a community health nursing perspective, the paper defines community, proposes an integrated knowledge development framework that focuses on community, analyses contemporary theoretical and philosophical foundations of community in nursing, considers three world-views in which nursing can be framed, and examines parameters for knowledge development for the future.

Community Health Nursing↗
PubMed1998

Youngsters caring for adults with cancer.

PURPOSE: To describe the caregiving provided by children and adolescents for adults with cancer. Because nurses are assuming an increasingly prominent role in working with caregivers, it is necessary to understand young caregivers. DESIGN: The population of interest was youngsters aged 10 to 19 caring for adults at home with cancer. Eleven children and adolescents in seven families were recruited, 1993-1994, through purposive sampling from hospices and cancer clinics. METHODS: Phenomenologic interviews, ethnographic interviews and selected participant observation experiences, and identification of needs through an unstructured survey were used. FINDINGS: "Hard, but gratifying" emerged as the dominant phenomenologic description of caregiving. Emergent ethnographic themes indicated caregiving by children and adolescents was an expectation of family life. School and church were described as avenues for social support for youngsters in care-giving situations. CONCLUSIONS: Youngsters aged 10 to 19 are caring for adults with cancer at home. Further descriptive study of youngsters caring for adults with cancer is needed.

Adaptation, Psychological↗
PubMed1997

Combining the analyses of three qualitative data sets in studying young caregivers.

Adolescent care of the adult with cancer led the authors to choose three qualitative methods to describe this unexplored phenomenon. In this study, phenomenology, ethnography and unstructured survey were combined to provide a more complete picture of the phenomenon. Data from interviews with 11 youngsters within seven family units, observations, and unstructured questionnaire, demographic data from and field notes were analysed and combined. The processes used in designing and conducting the study and analysing the data, rather than the findings, are emphasized. The data obtained by using these three methods have laid the foundation for further nursing research on caregiving by youngsters and raise questions about combining analyses of three qualitative data sets.

Adolescent↗
PubMed1996

Needs of caregivers of clinic and hospice cancer patients.

This prospective correlational study compared the self-identified needs of 55 caregivers of clinic (n = 25) and hospice (n = 30) cancer patients. Patients identified their family caregivers who filled out the Home Caregiver Need Survey (HCNS) and a demographic data form. The HCNS measures the importance and satisfaction of needs on two seven-point Likert-type scales. Descriptive statistics and t tests were used to analyze the data. Caregivers of both clinic and hospice cancer patients ranked the needs items in the Information and Spiritual categories as most important. Variation in types of information occurred between the groups. Clinic caregivers were less satisfied with how well their needs in the Information category were met. Differences between the groups in the importance scores were significant at the 0.001 level for the needs in the Patient Care and Personal Care categories. Differences in the satisfaction scores between the groups were significant at the 0.001 level for needs in the Household and Patient Care categories. The HCNS is helpful for assessing and screening caregiver needs and identifying differences in needs between groups. Health care providers in clinics and hospices must individualize teaching to meet the specific needs of caregivers, particularly those needs related to information.

Adolescent↗
PubMed1996

Applying advanced directives regulations in home care agencies.

As Dombi (1991) indicated, home healthcare agencies see people in their own settings and can be most influential in assisting clients and families to deal with important issues. Furthermore, in receiving care in their homes, clients and their families may be in a more amenable frame of mind to consider such issues. Agencies may find it helpful to identify special resource people who could be accessible to clients and families in enabling them to prepare appropriate documents. In a tape recording that reviews the state of life-sustaining therapy, Wolf (1993) highlighted the importance of seeing the regulations on advance directives as just the beginning of further work and discussion with clients and their families. Home healthcare agencies, in particular, need to do more than just comply with directives related to the Patient Self-Determination Act. Agencies can be in the forefront of identifying needs and concerns of clients and families related to critical life and death decisions and in exploring the ramifications of those decisions. The trend toward developing ethics committees in home healthcare agencies can be a vehicle for further exploration of such issues.

Advance Directives↗
PubMed1994

Uniting the past and the future in public health nursing: the Michigan Oral History Project.

In 1987 a group of Michigan public health nurses recognized the need to capture the richness of the lives of renowned public health leaders by collecting and preserving their oral histories. With the assistance of the Bentley Collection at the University of Michigan, the Michigan Oral History Project found a home. In this paper, the process of designing and implementing the oral history project is described within the framework of McBride's Orchestrating the Stages of a Career, adapted from the Dalton/Thompson/Price career development model. The steps in selecting interviewers and leaders, conducting the interviews, and keeping track of the completed work are outlined. Finally, the early results and potential uses for the collected data are discussed. This project has special significance in this year for the celebration of the centennial of public health nursing.

Biographies as Topic↗
PubMed1992

The attitudes of beginning nursing and medical students toward care of dying patients: a preliminary study.

The attitudes of entering classes of nursing and medical students toward the care of dying patients were compared using a self-administered instrument designed for the study measuring aversive and attractive components of these attitudes. Both groups exhibited similar aversive attitude items: Talking About Death elicited the most negative scores, General Interaction was slightly less negative, and Touching was the least negative. Among the attractive items, medical students were more positive on the Professional Challenge subscale, while the nursing students were more positive on the Personal Satisfaction subscale.

Adult↗
PubMed1991

Transcultural comparison of hospital and hospice as caring environments for dying patients.

Leininger's nursing Theory of Cultural Care Diversity and Universality provided the framework for this comparative study of two environments for persons who are dying; namely a hospital oncology unit and a free-standing hospice unit. Analysis of data from ethnographic and ethnonursing research methods including unstructured interviews, observation-participation, and field journal materials yielded contrasts with two settings. The presence of a caring atmosphere/ambience was apparent in both the hospital and hospice. Universal patterns common to both were: caring beliefs and practices of staff; identification of each setting as "community" or "home"; and multiple symbolic uses of humor and food. Diversities included hierarchical organizational structure and cure orientation in the hospital; interdisciplinary collaboration and care orientation in hospice; more pronounced use of touch as a caring modality; and greater evidence of symbolism and ritual related to death and dying in hospice. Adoption of the cultural care modes of accommodation, repatterning, and maintenance are suggested in promoting a caring atmosphere wherever dying patients are served.

Cultural Characteristics↗
PubMedDate not supplied

Needs of hospice and clinic patients with cancer.

The purposes of this descriptive study were: (1) to compare the self-selected needs of 69 patients with cancer, 31 from a nonprofit hospice, and 38 from a university cancer center located in the mid-south; and (2) to establish the reliability of the Cancer Patient Need Survey for hospice patients. Patients completed the Cancer Patient Need Survey and a demographic data form. Hospice and clinic patients rated the category of coping needs most important. Clinic patients also ranked the category of information needs as a priority, but did not find these needs as well met. Both groups ranked as their top individual needs support from family and friends, and a patient caregiver. Reliabilities of the instrument for the groups range from 0.91 to 0.93. The Cancer Patient Need Survey is a useful instrument for assessing and testing the needs of clinic patients, but additional work needs to be done in modifying the instrument for use with hospice patients.

Adult↗